MEDICARE: CADE FULLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist		IA

General Provider Information

NPI Number	:	1609710078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CADE FULLER

Provider Business Mailing Address
First Line	:	2122 YORK RD STE 300
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1925
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	912 VIKING RD STE 101
Second Line	:
City	:	CEDAR FALLS
State	:	IA
Zip	:	50613-9536
Country	:	US
Telephone Number	:	319-449-6055
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2026
Last Update Date	:	04/16/2026

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Directions to “ CADE FULLER ” Practice Location

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